Diagnostic Value of I/T2 Ratio in Neonatal Sepsis: A Prospective Comparative Study.

Background: Neonatal sepsis accounts for early-half of all neonatal death in India. Although the gold standard for the diagnosis of neonatal sepsis is by blood culture, there is a need for a test that is cheap, accurate, easily performed with quick availability of reports so that prompt and appropriate treatment is ensured. In this study we try to analyse the diagnostic value of I/T2ratio in comparison to I/T ratio and absolute neutrophil count (ANC) independently to correctly predict neonatal sepsis. Subjects and Methods: A time bound, prospective comparative study was done on neonates with suspected neonatal sepsis for a 2 year period. Neonates were then analysed in three groups depending on their blood culture results as no sepsis, probable sepsis and proven sepsis. I/T2was calculated for all the babies and an optimum cut off was found for the same. The diagnostic accuracy of I/T2 ratio with septic screen positivity and blood cultures were assessed. Results: 245 neonates included in the study were divided into three groups depending on whether they were blood culture positive sepsis, probable or clinical sepsis. The means of septic screen parameters including I/T2 were highly significant when compared between the three groups (p value <0.001). ROC curve created showed the AUC for I/T, I/T2 and ANC was 0.822, 0.809, 0.610 (p value <0.001) and a higher specificity. Conclusion: I/T2 shows promise as a parameter to screen for sepsis in neonates. Calculating the I/T2 ratio in conjunction with established septic screen parameters could enhance prediction of sepsis in newborns.